Perceived family functioning and friendship quality: cross-sectional associations with physical activity and sedentary behaviours

Total and temporal patterning of physical activity in adolescents and associations with mental wellbeing

BACKGROUND

There is limited understanding of the extent to which differences in physical activity across the day and week may be associated with mental wellbeing. Such an understanding is needed for better targeting of interventions. In this study, we describe total and temporal patterning of physical activity across the week in adolescents (age 13-14y) and assess their prospective associations with mental wellbeing.

METHODS

1,983 13-14-year-old adolescent participants based in Cambridgeshire and Essex, recruited between 2016 and 2017 into the Get Others Active Trial provided data at baseline and 4 months. Physical activity was measured at baseline using wrist-worn accelerometers across different time segments (whole week, weekday schooltime, weekday out of school, and weekend), and operationalized as average movement-related acceleration for each time segment. Mental Wellbeing at baseline and 4 months was measured using the Warwick Edinburgh MentalWellbeing Scale. Associations between physical activity across different time segments (whole week, weekday schooltime, weekday out of school, and weekend) and mental wellbeing at 4 months were investigated using sex-stratified multi-level regression models, adjusted for covariates, and both adjusted and unadjusted for baseline mental wellbeing.

RESULTS

Our analyses found positive associations between physical activity and mental wellbeing at 4 months, unadjusted for baseline wellbeing. Among girls, positive associations were shown when considering physical activity across the whole week 0.07 (95% CI, 0.03-0.12), and across all separate time periods studied: weekday schooltime 0.07 (95% CI, 0.02-0.11), weekday out-of-school time 0.07 (95% CI, 0.03-0.12), and weekend 0.07 (95% CI, 0.02-0.11). For boys, similar associations were observed for activity across the week 0.07 (95% CI, 0.03-0.11), during weekday schooltime 0.08 (95% CI, 0.04-0.12), and weekday out-of-school time 0.07 (95% CI, 0.03-0.11), but not the weekend 0.01 (95% CI, -0.03-0.05). For both girls and boys, associations were attenuated below significance after adjusting for baseline wellbeing.

CONCLUSIONS

This longitudinal analysis showed positive associations between physical activity and later mental wellbeing in both male and female adolescents across most time segments. Higher physical activity throughout the week may be associated with better mental wellbeing in the adolescent population. Further research is required to understand determinants of change in wellbeing over time.

TRIAL REGISTRATION

Registration Number: ISRCTN31583496. Registered: 18/02/2014.

Social isolation is associated with higher leisure-time sedentary behavior and lower physical activity practice: A multi-country analysis of data from 79 countries from the Global School-Based Student Health Survey

AIM

To investigate the association of social isolation with physical activity and leisure-time sedentary behavior among adolescents.

METHODS

We used data from the Global School-based Health Survey, including a representative sample of 296,861 adolescents (11-18y) from 79 countries (48.9% girls, 14.5 ± 1.6 years). Social isolation was estimated by combining the self-reported number of friends and loneliness perception. Physical activity and leisure-time sedentary behavior were assessed through questionnaires. Multinomial logistic regression models were created to analyze the associations of social isolation with physical activity and leisure-time sedentary behavior.

RESULTS

Compared with those practicing ≥60 min of physical activity during 1-4 days/week, social isolation was associated with a higher prevalence of not practicing physical activity (Prevalence ratio [PR]:1.24; 95%CI:1.19-1.29), and a lower prevalence of practicing during ≥5d/wk. (PR:0.91; 95%CI:0.88-0.94). Compared with <4 h/d of leisure-time sedentary behavior, being socially isolated was also associated with a higher prevalence of 4-7 h/d (PR: 1.08; 95%CI:1.03-1.14) and ≥ 8 h/d (PR: 1.24; 95%CI:1.16-1.33) of leisure-time sedentary behavior. Compared with those participants without elevated leisure-time sedentary behavior and with those practicing adequate physical activity, social isolation was independently associated with a higher prevalence of physical inactivity (PR: 1.20; 95%CI: 1.15-1.26) and elevated leisure-time sedentary behavior (PR: 1.21; 95%CI: 1.14-1.30), as well as with both risk factors simultaneously (PR: 1.36; 95%CI: 1.28-1.45).

CONCLUSION

Reducing social isolation could be an important component of future interventions to reduce sedentary behavior and physical inactivity among adolescents.

Levels of Physical Activity, Family Functioning and Self-Concept in Elementary and High School Education Students: A Structural Equation Model

In the adolescent population there is great concern about low levels of physical activity and low levels of family awareness of the benefits of physical exercise on physical and mental health. This study aims to determine the influence of physical activity levels, family functioning and self-concept in primary and secondary school students, as well as to develop a structural equation model as a function of weekly physical activity time. A descriptive, cross-sectional, comparative study was conducted on whether students engage in more than three hours of physical activity per week. To collect the data, instruments validated by the scientific community were used, such as the Adaptability, Partnership, Growth, Affection, and Resolve family questionnaire (APGAR) and the self-concept questionnaire form 5. The results show that those students who engage in more than 3 h of physical activity per week have higher levels of family functioning than those who do not meet this sport criterion. In addition, physically active students show higher scores on all dimensions of self-concept than those who practice less than 3 h of physical activity per week. Finally, as a conclusion, it can be affirmed that the amount of physical activity practice brings benefits to student's mental health.

The Role of Parental Support and the Students' Opinions in Active Finnish Physical Education Homework

Prior research indicates that adolescent boys are often more active than girls, implying a need for special attention to increase the physical activity levels of adolescent girls. Adolescents are at an age where they are especially susceptible to environmental and social influences but still have a limited amount of autonomy over their own behaviors. The effective physical activity programs implemented at this age may benefit health into adulthood. The fact that adolescents' physical activity is influenced by many factors indicates that to achieve any behavioral change, interventions must target several levels across the socio-ecological model. During childhood, the family is the primary factor in socializing and shaping engagement in physical activity. This study is part of the Physical Education (PE) Homework Study project which was implemented in a midsized secondary school in the middle of Finland from 2016 to 2020. The goal was to develop one easily approachable way to prevent the decreasing physical activity of adolescent girls. This was done by increasing physical activity times of adolescent girls outside of the school by giving them active PE assignments. The aim was also to explore students' and their parents' perceptions of physically active physical education homework. In this part of the study, there were 43 interviews: 38 student interviews and 5 interviews with parents. The analysis process followed the qualitative content analysis (QCA) strategy by Schreirer. In this study, we combined the views of students and parents, and obtained a broad picture of the PE homework assignments given at school but completed at home. According to students and parents, PE homework assignments should be diverse, interesting, and challenging, they should also be provided at flexible schedules outside of school hours with family support. Physical education homework could be a potential approach to influence the physical activity of the student population by involving school curriculum and families.

Risk and Protective Factors for Physical Activity Engagement Among Adolescents With Comorbid Asthma and Obesity

OBJECTIVE

The current study identifies levels of physical activity (PA) engagement among adolescents with neither asthma nor overweight/obesity (OW/OB), one, or both conditions. Risk and protective factors are examined across groups.

METHODS

Data from 8th, 9th, and 11th graders were obtained from the 2019 Minnesota Student Survey (N = 125,164). One-way analysis of variance was used to assess PA levels across risk groups. Linear regressions were used to examine patterns of risk and protective factors for adolescent PA engagement across four groups (neither asthma nor OW/OB, asthma only, OW/OB only, and comorbid asthma + OW/OB). Results were stratified by race/ethnicity.

RESULTS

Adolescents with OW/OB only or asthma + OW/OB had significantly lower PA levels than youth with asthma only or neither condition (M = 3.65-3.67 days/week, SD = 2.20 vs M = 4.15-4.19 days/week, SD = 2.16-2.17, p < .001). The following variables were associated with adolescent PA (p < .001): Adult community care across all risk groups (β ranges = .13-.16), depressive symptoms among those with neither and both asthma + OW/OB (β's = -.10), and extracurriculars among those with asthma + OW/OB (β = .10). Extracurriculars and parent connectedness were protective for Hispanic adolescents.

CONCLUSIONS

Adolescents with OW/OB had significantly lower levels of PA compared to those without, regardless of asthma status. Individual and relational factors influenced adolescent PA. Future research investigating factors influencing adolescent PA should consider depressive symptoms, connectedness to adults in the community, non-sport-related extracurricular activity involvement, and address disparities among minoritized youth.

Subjetividades de los adolescentes con respecto a la promoción de la salud: contribuciones a la enfermería

Introducción: Los adolescentes representan una parte importante de la población con particularidades relacionadas con el estilo de vida, por lo que es necesario promover acciones que fomenten hábitos saludables. En esta perspectiva, comprender las subjetividades que influencian los comportamientos de salud típicos de la adolescencia se vuelve esencial para la salud y la atención de enfermería, ya que las opciones de autocuidado están marcadas de singularidades. Objetivo: Exponer las subjetividades de los adolescentes sobre el autocuidado en el contexto de la promoción de la salud y la enfermería. Materiales y Métodos: Enfoque de investigación fenomenológica heideggeriana con 17 adolescentes de una escuela pública en Minas Gerais realizada entre octubre y diciembre de 2016. El movimiento analítico hermenéutico permitió la aparición del fenómeno en estudio. Resultados: Sobre el autocuidado, los adolescentes expresaron que van al médico sólo cuando se necesita; saben que tienen que cuidar su salud, pero no hacer ejercicio o comer de forma saludable y cuidar su salud ahora, sino porque en el futuro puede convertirse en un problema. De los participantes, el 68% reportó haber desarrollado actividad física durante las clases de educación física y el 30% informó haber consumido alcohol. Discusión y Conclusiones: Al comprender las subjetividades de los adolescentes sobre el autocuidado, las enfermeras encuentran mayores elementos para realizar acciones de salud dirigidas a estimular comportamientos saludables que resultarán una mejor calidad de vida en el presente y a futuro. Como citar este artigo: Paula JA, Melo MCSC, Amorim TV, Salimena AMO, Paiva ACPC, Nascimento RCN. Subjetividades de adolescentes face à promoção da saúde: contribuições para a enfermagem. Rev Cuid. 2020; 11(1): e895. http://dx.doi.org/10.15649/cuidarte.895

The Effects of Parental Stress on Physical Activity Among Overweight and Obese Hispanic Adolescents: Moderating Role of Family Communication and Gender

BACKGROUND

Previous literature has shown a negative relationship between parental stress and youth moderate to vigorous physical activity (MVPA). This study examined (1) the relationship between parental stress and adolescent MVPA, (2) the moderating role of family communication on this relationship, and (3) gender differences in these effects among overweight and obese Hispanic adolescents.

METHODS

Hispanic adolescents (N = 280, 52% female, 13.0 [0.8] y old, 44% obese, 12% severely obese) and their parents (88% female, 44.9 [6.5] y old) completed baseline measures for an efficacy trial. Adolescents self-reported MVPA in minutes per week for work, transportation, and recreation using a validated measure. Multiple regression analyses with interaction terms and multigroup methods were conducted.

RESULTS

There was a negative effect of parental stress on adolescent MVPA (β = -0.15, t = -2.018, P ≤ .05). This effect was moderated by family communication (β = 0.20, t = 2.471, P = .01), such that the association between parental stress and youth MVPA was stronger for adolescents with low levels of family communication. Furthermore, a multiple group model showed that the interaction was significant for boys (β = 0.27, t = 2.185, P = .03), but not for girls.

CONCLUSIONS

Findings provide support that addressing parental stress and family communication may help facilitate MVPA among Hispanic boys, the most at-risk group for pediatric obesity.

Associations of sedentary behaviors and physical activity with social isolation in 100,839 school students: The Brazilian Scholar Health Survey

OBJECTIVE

To examine the relationship between physical activity, sedentary behaviors, and social isolation in a representative sample of Brazilian adolescents.

METHOD

Cross sectional analyses using data from the Brazilian Scholar Health Survey conducted in 2015. The sample included 100,839 adolescents (mean age: 14.3 y, 51.4% Female) from 3040 schools. Information about social isolation (number of close friends and perceived loneliness), physical activity (International Physical Activity Questionnaire) and sedentary behaviors (total sitting time and TV viewing) were self-reported. Chronological age, race and type of city (state capital or other) were co-variables. Logistic regression models were used to analyze the data (results are presented as odds ratios (OR) with 95% confidence intervals).

RESULTS

Physical activity was associated with lower odds of both social isolation indicators in boys, and with lower likelihood of having few friends in girls. Greater sitting time was associated with higher likelihood of social isolation, as was low (<1 h/d) [boys: OR: 1.54 (95% CI: 1.33 to 1.77); girls: OR: 1.31 (95% CI: 1.17 to 1.48] and high TV viewing (≥8 h/d) [boys: OR: 1.75 (95% CI: 1.47 to 2.09)]; girls: OR: 1.58 (95% CI: 1.37 to 1.82)]. More than 300 min/week of physical activity was sufficient to eliminate the association of high TV viewing and high sitting time with markers of social isolation in boys.

CONCLUSION

Physical activity is associated with a lower prevalence of social isolation, especially among boys. Both high and low amounts of TV viewing increase the likelihood of social isolation. Physical activity reduced the association between TV viewing and sitting with social isolation among boys.

Conceptualizing Family Influences on Children's Energy Balance-Related Behaviors: Levels of Interacting Family Environmental Subsystems (The LIFES Framework)

Healthy or unhealthy behavioral patterns develop and are maintained in a family context. The importance of the family environment for children’s and adolescents’ energy balance-related behaviors (EBRBs) has been shown previously. However, the way different family environmental factors are interrelated and interact with personal factors (e.g., motivation) are not well understood. Furthermore, the majority of studies have focused on the parent-child subsystem. However, there are family-level socialization dynamics that affect the development of a healthy lifestyle beyond the impact of parenting behaviors. The current paper aims to synthesize theoretical and empirical literature on different types of family influences. The Levels of Interacting Family Environmental Subsystems (LIFES) framework incorporates family influences on three levels (immediate, proximal, distal) and of three subsystems (individual, parent-child, family), relates them to each other and postulates potential paths of influence on children’s EBRBs. Several studies examining specific sections of the framework provide empirical support for LIFES’ propositions. Future studies should place their research in the context of the interrelationship of different family environmental influences. A better understanding of the interrelated influences would enhance the understanding of the development and maintenance of overweight and obesity among children and is crucial for the development of effective interventions.

Familias Unidas for Health and Wellness: Adapting an Evidence-Based Substance Use and Sexual Risk Behavior Intervention for Obesity Prevention in Hispanic Adolescents

We describe the adaptation of Familias Unidas, an evidence-based substance use and sexual risk behavior intervention, for obesity prevention in Hispanic adolescents. Intervention developers and experts in pediatric obesity, exercise physiology, dietetics, and the local parks system provided input for changes. Hispanic families also provided input through a series of 21 focus groups conducted before, during, and after an initial pilot test of the adapted intervention. After transcribing audiotaped sessions, we used a general inductive approach and Dedoose qualitative software to derive themes. Results indicated the need for improved health-related family functioning, enhanced nutrition education and skill building, increased family engagement in physical activity, and stronger links between family and environmental supports. Parents who participated in the pilot test expressed high enthusiasm for hands-on nutrition training and reported improvements in family functioning. Adolescents liked outdoor physical activities but wanted parents to be more engaged in joint physical activity sessions. The adapted intervention maintains fidelity to Familias Unidas' core theoretical elements and overall structure, but also includes content focused on physical activity and nutrition, adolescent participation in physical activity sessions led by park coaches, and joint parent-adolescent participation in physical activity and nutrition skill-building activities.

Childhood predictors of adolescent behaviour: The prospective association of familial factors with meeting physical activity guidelines

Little is known about the longitudinal association of familial socio-demographic factors, behaviours, attitudes, or home environment with meeting physical activity guidelines. Our objective was to a) describe 4-year change in the prevalence of meeting guidelines, and characteristics of participants across categories of physical activity maintenance, and b) identify familial factors in childhood that are longitudinally associated with meeting guidelines in adolescence. Data on 17 parent- and child-reported family variables and objectively measured physical activity (ActiGraph GT1M) were available from 406 children (10.3 ± 0.3 years, 53.5% female) participating in the SPEEDY study. Average duration of week- and weekend day moderate-to-vigorous physical activity (MVPA, ≥ 2000 cpm) at baseline and follow-up (14.3 ± 0.3 years) were calculated to determine whether participants met 60 min MVPA/day guidelines at each assessment. Descriptives were calculated across four MVPA change categories. Multi-level logistic regression examined the association of baseline familial factors with meeting guidelines at follow-up, adjusting for sex, baseline physical activity, family socio-economic position, and school clustering. At follow-up, 51.5% and 36.1% of adolescents met guidelines on weekdays and weekend days, respectively (baseline: 68.0%, 67.2%). Girls were less likely than boys to remain sufficiently active, particularly on weekdays. Family social support was positively associated with adolescents meeting guidelines at weekends (OR 1.2; 95% CI 1.0-1.4). The presence of play equipment at home was negatively associated with meeting guidelines on weekdays (OR 0.5; 95% CI 0.3-0.8). Interventions that foster parent's facilitation of physical activity may help to encourage the upkeep of healthy behaviours during the transition from childhood to adolescence.

Cognitive and Motivational Factors Associated with Sedentary Behavior: A Systematic Review

Excessive time spent in sedentary behavior (SB) is associated with numerous health risks. These associations remain even after controlling for moderate-to-vigorous physical activity (PA) and body mass index, indicating that efforts to promote leisure time physical activity alone are insufficient. Cognitive and motivation variables represent potentially modifiable factors and have the potential of furthering our understanding of sedentary behavior. Hence, a systematic review was conducted to synthesize and critique the literature on the relationship between cognitive and motivational factors and sedentary behaviors. In April 2016, four electronic databases (Psych info, Pub Med, SPORTDiscus, Web of Science) were searched and a total of 4866 titles and abstracts were reviewed. After meeting inclusion criteria, study characteristics were extracted and the methodological quality of each study was assessed according to the Downs and Black Checklist. PRISMA guidelines for reporting of systematic reviews were followed. Twenty-five studies (16 cross-sectional, 8 longitudinal and one examining two populations and employing both a cross-sectional and prospective design) assessed 23 different cognitive and motivational factors. Seventeen studies were theory-based and 8 did not employ a theoretical model. Results showed that among SB-related cognitions, risk factors for greater sedentary time included having a more positive attitude towards SB, perceiving greater social support/norms for SB, reporting greater SB habits, having greater intentions to be sedentary, and having higher intrinsic, introjected, and external motivation towards SB. Protective factors associated with lower sedentary time included having greater feelings of self-efficacy/control over SB and greater intentions to reduce SB. Among PA-related cognitions, protective factors for lower SB included a more positive attitude towards PA, having greater social support/norms for PA, greater self-efficacy/control for PA, higher PA intentions, and higher intrinsic and identified motivation towards PA. In addition, feeling more supported and empowered in general was related with lower levels of SB. The average methodological quality score for included studies was 69% (SD = 9.15%; range 35–80%). In conclusion, a number of cognitive and motivational factors were identified that were associated with sedentarism. These findings have come from reasonably high quality studies. To further extend our understanding of the relation between cognitive and motivational factors and SB, more longitudinal, theory-driven studies examining cognitions and motivation from a sedentary perspective are required.

Revising on the run or studying on the sofa: prospective associations between physical activity, sedentary behaviour, and exam results in British adolescents

BACKGROUND

We investigated prospective associations between physical activity/sedentary behaviour (PA/SED) and General Certificate of Secondary Education (GCSE) results in British adolescents.

METHODS

Exposures were objective PA/SED and self-reported sedentary behaviours (screen (TV, Internet, Computer Games)/non-screen (homework, reading)) measured in 845 adolescents (14·5y ± 0·5y; 43·6 % male). GCSE results at 16y were obtained from national records. Associations between exposures and academic performance (total exam points) were assessed using multilevel mixed-effects linear regression adjusted for mood, BMI z-score, deprivation, sex, season and school; potential interactions were investigated.

RESULTS

PA was not associated with academic performance. One-hour more accelerometer-assessed SED was associated with (β(95 % CI)) 6·9(1·5,12·4) more GCSE points. An extra hour of screen time was associated with 9.3(-14·3,-4·3) fewer points whereas an extra hour of non-screen time (reading/homework) was associated with 23·1(14·6,31·6) more points. Screen time was still associated with poorer scores after adjusting for objective PA/SED and reading/homework.

CONCLUSIONS

An extra hour/day of screen time at 14·5y is approximately equivalent to two fewer GCSE grades (e.g., from B to D) at 16y. Strategies to achieve the right balance between screen and non-screen time may be important for improving academic performance. Concerns that encouraging more physical activity may result in decreased academic performance seem unfounded.